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South Dakota rates for HCPCS J9153

Injection Liposomal 1 Mg Daunorubicin And 2.27 Mg Cytarabine

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$256.08 / $256.08 / $256.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.08 / $256.08 / $308.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.73 / $256.08 / $317.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$255.09 / $431.10 / $510.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.09 / $283.97 / $1,096.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$298.08 / $322.93 / $405.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.87 / $309.83 / $382.64
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.24 / $280.24 / $280.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.08 / $256.08 / $304.75
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$279.16 / $279.16 / $279.16
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.16 / $279.16 / $279.16